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VOLUME 5 , ISSUE 2 ( December, 2018 ) > List of Articles
Jai P Khatri, Ajaydeep Sud, Vandana Rana, Munish Sood, Uddandam Rajesh
Keywords : Ankle, Giant synovial osteochondroma, Primary
Citation Information : Khatri JP, Sud A, Rana V, Sood M, Rajesh U. Primary Giant Synovial Osteochondroma of Ankle. J Foot Ankle Surg Asia-Pacific 2018; 5 (2):73-76.
License: CC BY-NC 4.0
Published Online: 01-12-2018
Copyright Statement: Copyright © 2018; The Author(s).
Background: Giant synovial osteochondroma (SOC) is a clinical variant of synovial chondromatosis wherein the size of the osteochondral nodule exceeds 2 cm. This is a rare clinical entity and finds its description in a few case reports or case series only. Case description: A 28-year male patient presented with swelling of the ankle region for 5 months duration. Plain radiograph of the ankle showed well circumscribed, increased soft tissue density lesion in the posterior aspect of tibiotalar joint and talus. Magnetic resonance imaging (MRI) of the ankle showed a smoothly marginated lesion close to the tibiotalar joint which was heterogeneously hypointense on T1-weighted images and hyperintense on T2-weighted images. Hypointense foci within the lesion in both images were suggestive of ossification. Intraoperatively, the swelling was noted to arise from the tibiotalar joint capsule with no evidence of bony erosion. The mass was excised in toto, and wound closure was done in layers. Microscopic examination of the mass showed predominant chondroid element with irregularly distributed chondrocytes in lacunae and evidence of enchondral ossification along with cancellous bone mass suggesting a synovial osteochondroma. On postoperative follow-up at 2 months and 9 months, movements around ankle joint were full range and pain-free with no reappearance of swelling. Imaging including plain radiograph and MRI revealed no evidence of recurrence at 9 months. Conclusion: Giant SOC can present itself with the variety of symptoms. Imaging is helpful in ascertaining the diagnosis. The treatment of the condition remains surgical only. Post surgery, recurrence remains a possibility. Clinical significance: Giant SOC should form one of the clinical possibilities in swellings arising from synovial joints as early diagnosis of the condition can prevent arthritic changes to progress further.
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